High dose cytosine arabinoside is a major risk factor for the development of hepatosplenic candidiasis in patients with leukemia.
A retrospective study of hepatosplenic candidiasis in patients with acute leukemia from a single centre was performed. The significance of age, sex, type of leukemia, dose of cytosine arabinoside (Ara-C), duration of neutropenia, steroid use and period of therapeutic antibiotics in the development of hepatosplenic candidiasis was analyzed, using logistic regression analysis. Nine of 51 patients had hepatosplenic candidiasis. Ara-C use was highly associated with the development of hepatosplenic candidiasis (p = 0.001); with a high association with a higher dose (p < 0.0001). On the basis of these results consideration should be given to further trial of antifungal prophylaxis for patients receiving high dose Ara-C.
Woolley
I
I
Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Curtis
D
D
Szer
J
J
Fairley
C
C
Vujovic
O
O
Ugoni
A
A
Spelman
D
D
D000328:Adult; D019072:Antibiotic Prophylaxis; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002177:Candidiasis / Q000209:etiology* / Q000517:prevention & control; D003561:Cytarabine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D009894:Opportunistic Infections / Q000382:microbiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors
D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine